Propecia Before a Hair Transplant… and Does Stress Speed Up MPB?

Dear Dr,

Your Q and A’s are absolutely priceless in an industry where most people would not know where to start looking to gather info, so thank you for that. I have a couple of questions. I’ve read quite alot of your site now and have grasped most of what I need to know but would like to ask you about my specific case now if I may.

I am 27 and have been a Norwood 2 for 3-5 years and thought it was my mature hairline. But within the last year I had drastic life changing circumstances and alot of stress. That lasted to 4-6 months and I noticed I started losing hair around the temples(windows peak area) quite rapidly but in an even MPB fashion. I thought at the beginning it was stress induced but as it was happening evenly around both temples I thought after reading alot of your site that its just MPB getting stronger or whatever. Thus here are my questions!! :)

1. Started Propecia and it is working amazing, from the first few days hair stopped falling out and every week it gets better. 1-2 hairs from a 4-5 day bedding wash cycle is all I get on the pillow now. I have been on it for 4 months now and obviously will continue for good, who knows what else will happen. But my Q is this, I want to get a hair transplant soon and fill up what I lost so I have all my hair back and keep the hairline I had which is windows peaks, which im fine with, suits my face and age etc.. But I was wondering. Do you think I should wait for 8 more months to see what Propecia can do before getting one or will it continue to improve wherever anyway in conjunction with the transplant?
2. And secondly do you think in general stress really can speed up MPB evenly falling out like mine was? And if hair does fall out from stress does it ever grow back like it was before the event? Or is stress and MPB just to hard to diagnose other than on a case to case basis. Thank you so much for your time!

I’m glad you enjoy the site and find it useful. Thanks for visiting and writing.

I usually recommend to young men like yourself with male pattern baldness (MPB) that are interested in hair transplantation to get on Propecia for at least a few weeks before going for a surgery as you want the drug to bind to the hair follicle tissue to get a protective effect. In some people, waiting even longer than a few weeks may have value in seeing the benefit of the drug over time when the hair loss is still early.

Stress can certainly cause hair loss, and in men that are genetically programmed to lose hair, stress can speed up that timeframe. For those without MPB, stress-induced loss might regrow… but for those with MPB, stress-induced acceleration of hair loss is unlikely to see any regrowth even upon getting the stress under control.